Reconstruction of Philtrum Using Partial Splitting and Folding of Orbicularis Oris Muscle in Secondary Unilateral Cleft Lip

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Abstract

Background:

The reconstruction of the philtrum during unilateral cleft lip repair remains a surgical challenge. The authors introduce a modified surgical technique for the reconstruction of the philtrum that allows for both the deepening of the philtral dimple and augmentation of the philtral ridge.

Methods:

Between January of 2011 and June of 2012, 37 patients, including 22 male and 15 female patients (mean age, 25.6 years), underwent secondary unilateral cleft lip repair. The philtrum was reconstructed by the partial splitting and folding of the orbicularis oris muscle. The aesthetic outcome of the philtrum and the scar after the operation was scored to evaluate the effectiveness of the procedure.

Results:

The patients were evaluated for the appearance of the philtrum and scar at 12 to 18 months (mean, 14.6 months). Good symmetry of the bilateral philtral ridges was achieved in 35 of the 37 patients, with the postoperative scores for aesthetic outcome being 2 to 4. The postoperative appearance of the scar in almost all cases was also significantly better than that before the operation. Only two patients showed widening of the philtral ridges and less prominent philtral ridges on the reconstructed side than on the normal side.

Conclusions:

The authors presented a new technique for the repair of the philtrum in patients with secondary unilateral cleft lip; the technique afforded good aesthetic outcomes in almost all cases.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.

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